Big Sky Benefit Solutions

In case of hospitalisation, the insurance company must be informed immediately. The time frame in planned or emergency hospitalisation may differ from insurer to insurer.

Knowing the claim settlement ratio helps you understand how well a particular insurance company manages claims so that you do not face any hassle at the time of claim settlement. When buying health insurance plans online, it is important to consider the claim settlement ratio of the insurance company in order to analyse the insurance company.

Claim Settlement Ratio or CSR in health insurance is the ratio of claims settled against the total number of claims admitted during a financial year. It is an accurate way to weigh an insurance company’s standing for claim settlement. For instance, if there were 100 claims admitted by an insurance company during a financial year, of which 93 have been settled, then the CSR will be 93% for that financial year.

Policyholders can appraise their insurance provider through e-mail or call. They can contact their customer representatives for the same. However, different insurers may have different routes to connect them.

Generally, insurance providers settle the claim request in a period of 7 working days from receiving the last relevant document, but, none of them takes more than 30 days.

Yes. While you can leave your entire death benefit to a single primary beneficiary, you may also select a contingent beneficiary. This person only receives money if the primary beneficiary dies or is unable to accept the money.You may also select more than one primary or contingent beneficiary and assign what percentage of the money each person will receive.

A death benefit is the money your beneficiary receives from the life insurance company after you die.

In most situations, life insurance premiums are not subject to sales tax.This means the premium amount quoted to you by the insurance company is the amount you pay. A percentage will not be added to cover taxes.However, life insurance premiums are not tax deductible, either.

Everyone’s situation is different. For many people, term life insurance is a good fit because it’s affordable and provides coverage during your primary income-earning years. However, permanent life insurance is ideal for people seeking lifelong coverage, tax advantages — and potentially — investment opportunities.

Life insurance is meant to ease financial hardship for your loved ones upon your death. Money paid out from your policy can be used to provide for financial dependents, pay off personal debts, replace your income, pay estate taxes, cover final expenses such as funeral costs or fund a charity endowment.

A beneficiary is the designated person on your policy who receives money from the insurance company after you pass away.

Life insurance is a contract between you and an insurance company. The insurer promises to pay a sum of money to a designated beneficiary after you die, and in exchange, you pay ongoing payments called premiums.

If you have a preferred doctor or hospital, check the list of network hospitals to ensure that you can avail their services or not since an out of network provider can turn out to be very expensive.

Health insurance comes with certain out-of-pocket costs like deductible and coinsurance. This amount is what you will have to pay out of your own pocket when you receive medical care. Check with your insurance provider for these charges. Also, find out the cost percentage that your health plan will cover once you have paid the deductible.

The cost of the plan is the monthly premium or the amount you pay per month to your insurer to keep your health cover active. Depending on the type of plan you choose and the amount of coverage you require, the cost can vary.

Certain health disorders require you to undergo routine medical check-ups. You must ask whether or not your plan will pay for your routine check-ups.

Policy exclusions are the conditions that the policy will not cover. Some insurance policies do not cover the treatment of certain diseases in the first year but after a waiting period. The exclusions in the policy may differ from one insurer to another, therefore being aware of these exclusions is equally important as that will help you decide which policy to buy.

Public liability insurance isn’t a legal requirement, but it’s highly recommended if the nature of your business means you regularly interact with the public, clients and contractors.Accidents happen, even when you’re doing all you can to avoid mishaps. A legal battle could be financially damaging to your business, especially if you wouldn’t have the means to settle a claim without the right insurance in place.While cover isn’t mandatory, it can provide key assistance. Since public liability cover won’t protect you retrospectively, it is a good idea to purchase insurance before you interact with clients or members of the public.

Home insurance does not cover claims which relate to the business. For this reason, it is important home-based business owners get insurance which meets their business needs. Some common insurance business insurance coverages include general liability insurance (which could help with costs if there is damage to the business property or a lawsuit due to a customer being injured) and business property insurance (which could cover costs to repair damage to a business owner’s home).

You may be able to deduct your insurance premiums for revenue expenses, as long as you can show that the purpose of the insurance relates to your ability to earn your assessable income or is required for carrying on a business for the purpose of earning assessable income. You should seek advice from your accountant on this.

Professional indemnity insurance covers you on what’s known as a ‘claims made basis’. This means that you need to have a current policy on the date that a claim is made against you, regardless of when your services were provided.

You need to choose an insurance company that understands your needs as a business owner. Look for a company that can recommend the correct coverages and has a knowledgeable claims staff should the unexpected happen. At American Family Insurance we protect the dreams of business owners.

All businesses need insurance to protect their dream. When you own a business, the unexpected can happen including injuries, accidents, lawsuits, or damage to your building or business property. Business insurance helps to protect your business when things don’t quite go as planned. Without it you could be putting your business, and your dreams, at risk.

The difference between public liability and employers’ liability insurance is that public liability insurance can cover your business in the case of third party compensation claims, while employers’ liability insurance can cover you in the case of employee (or ex-employee) injury compensation claims.

Public liability insurance can cover compensation claims if you’re sued by a member of the public for injury or damage, while professional indemnity insurance can cover compensation claims if you’re sued by a client for a mistake that you make in your work.

You can get business insurance before registering your business, and even before you’ve started trading. When you buy your business insurance you won’t usually be asked for your company registration number or any other business registration details.

You can buy your business insurance before you begin trading, so you may not have your trade licence in place yet. However, once you start trading, if your business still doesn’t have the necessary licences your business insurance may be invalid and claims may not be paid.

Insurance requirements vary based on each state's laws and regulations. It's a good idea to contact a local business insurance representative to understand what kind of coverage may be legally required in your state.

Small business insurance (sometimes called commercial insurance) helps protect a company's assets, income and property. Business property, general liability and business interruption coverage are typically included in a business insurance policy, but there are many optional coverages available to business owners as well.

In order for your business insurance to cover flood damage, your company must carry a separate flood insurance policy or endorsement. A typical commercial property insurance policy covers specific water damage situations but excludes flooding. The wording and water damage exclusions vary from one insurance company to another. Be sure to review your policy carefully and discuss your specific risks and concerns with an independent insurance agent who can help you get the coverage you need.

If your business carries commercial crime/theft coverage, your business insurance will cover employee fraud and embezzlement.There are several different forms of employee dishonesty coverage. You can purchase several types of fidelity bonds to protect the business in the event of dishonest acts by all employees, or by named employees.

Yes, you should include insurance expenses in your initial business plan and yearly budget. From a cash flow perspective, you'll want to understand what kind of payment options and timing are available. When starting out, aim to separate your company assets from your personal items to determine the amount of insurance you'll need to carry. To properly establish your new company, speak to a tax or legal advisor about formalizing the structure of your business.

The cost of insurance is based on a range of factors including the following:The value of the company assets you wish to insure.Number of employees.Specific risks associated with your industry.Your personal risk tolerance and the amount of liability protection you prefer.

Starting your own business means taking on some degree of risk. As a business owner, you already have the passion and drive to take on new challenges, but you'll also need to protect the value of the assets you purchase for your company. Insurance can help you recover when things go wrong. From property losses related to items such as fire or theft, to liability issues should someone sue – or threaten to. With the proper policies in place, you'll gain peace of mind and feel more comfortable in your new role as an entrepreneur.

Payments will be paid directly to you, not to the doctors, hospitals or other health care providers. You will receive a check payable to you

Premiums will be paid through payroll deduction, so you don't have to worry about writing a check or missing a payment.

Yes, you can use your payment as you see fit. Use it to help cover your household bills, medical insurance deductibles, and copayments.

No. These supplemental Insurances will be effective on the date of your coverage as long as you are actively at work. There are no waiting periods to satisfy.

Yes. These coverages are guaranteed issue, which means your acceptance is guaranteed, regardless of your health. You just need to be actively at work for your coverage to be effective.2There are no medical exams to take and no health questions to answer.

Accidents and critical illnesses can happen anytime, to anyone and when you least expect them – and they can be costly. Even quality medical plans can leave you with extra expenses to pay. Costs like plan deductibles, copays for doctor visits and extra costs for out-of-network care can add up fast. Having the financial support you may need when the time comes may mean less worry for you and your family.

Accident insurance coverage provides you with a lump-sum payment when you suffer a covered injury or undergo covered testing,medical services, or treatment and meet the group policy and certificate requirements. There are more than 150 covered events and there is no limit on the number of different accidents that will be covered.Payments are made directly to you to use as you see fit. They can be used to help pay for medical plan deductibles and copays, out-of-network treatments, for your family’s everyday living expenses, or whatever else you need while recuperating from an accident.

Yes. An insured may avail of more than one personal accident insurance provided that the limit of his coverage does not exceed the maximum benefit allowed based on the percentage of his Gross Annual Income.

In the absence of a named beneficiary, the beneficiary will be the estate of the insured or any relative by blood or connection by marriage who is deemed by the Company to be equitably entitled thereto.

If you own your own practice and become disabled, you may have overhead costs which you cannot easily get out of (leases, employee salaries, and other contracts) even though you can no longer generate income (whether temporarily or permanently). So consider whether you need a policy of some kind which will cover business overhead expenses in the case of a disability. In addition, if you own a practice with others, make sure you understand what will happen if you (or another member of the practice) are disabled and can no longer contribute to the profits, but still own a share of the practice. There are specialized “buy/sell” disability policies which help in this case.

You should of course seek medical attention for any potential condition which would require immediate treatment. However, consider postponing any elective or routine visits, which may turn up a new issue and lead to an exclusion or rejection. Consider a case where an annual visit finds a suspicious lump, or there is an elevated BP, abnormal lipid panel, etc. Even if these things turn out to be anomalous or benign, they can affect your DI. So consider temporarily delaying certain medical visits for which you don’t have an existing chief complaint if you are eminently considering purchasing disability insurance (or life insurance for that matter).

In general, group or association policies are cheaper than individual policies, for a given amount of coverage. This is typically because association/group policies are not “guaranteed renewable” and are not “non-cancellable”. However, the cost of an association policy is not fixed, and it can increase as you get older, and can get quite expensive later in life. In contrast, a strong individual DI policy should be guaranteed renewable and non-cancellable with fixed rates and terms as determined at the outset. These features can add to the cost.

Many employers will provide some amount of DI for employees, as part of a group policy which covers all employees. There is a very wide range in quality and coverage of these policies, which you cannot control because every employee must be offered the same policy. So you may want to consider your own independent policy to get the coverage which is appropriate for you. Some employer plans are quite good

It depends. Any policy which is paid for with pre-tax dollars, will have payments which are considered taxable. For example, employer provided policies, or policies you purchase which allow you to deduct the premiums from your taxes, will all result in taxable benefits. In contrast, your disability payments are tax-free if you (or someone on your behalf) purchases a policy where the premiums were made with after-tax dollars. If you are choosing your own policy, you should always pay with after-tax dollars, as opposed to paying through your business (if you have one) and deducting the cost as an expense.

Insurance companies typically do not sell disability insurance policies which replace all of your income. But, they do sell policies which can replace up to 70 percent of your income. If your employer does not offer a disability plan with 70 percent coverage, you may want to look for supplemental insurance coverage to offset the difference.One major benefit of owning your policy: When you pay premiums yourself, you are paying with after-tax dollars. Therefore, any benefits will likely be tax-free. Tax-free benefits paying 70 percent of your income comes close to being 100 percent of your take-home pay. If your employer pays the premiums and the cost is not included in your taxable income, then benefits will likely be subject to taxationA good rule of thumb is 70 percent coverage, but, as with all insurance needs, it depends on your circumstances and what you can afford. Regardless, seek out a qualified advisor if you need help crunching the numbers.

Your insurance contract will specify if you can receive benefits while working part-time. Many policies allow you to work, but take the amount you earn and subtract it from your benefit. If your policy has a lifetime benefit cap, working part-time may extend the life of your benefits.

Most disability insurance plans also stipulate a waiting period known as the “elimination period” between the time of your injury and the dispersal of benefits. The length of the elimination period depends on your plan. They can range anywhere from 30 days to one year, and the shorter the waiting period is, the more expensive your plan will be.Exactly how long a disability claim takes depends on the particular policy and the individual circumstances surrounding the claim. It could be right away, it could be months. So, no matter what sort of plan you have, make sure you know the details of your agreement. Talk to an insurance provider and read up on your policy’s terms so you can be certain that your coverage will be there if and when you need it.

There are a few possible reasons why your insurance company might decide to deny your claim. If your particular injury or illness is expressly excluded from your policy or if the insurance company has any reason to doubt your doctor’s prognosis, there’s a chance your provider will withhold your disability benefits. What happens next depends on the type policy you have, but if your claim does happen to be denied, it doesn’t necessarily mean you won’t receive your disability benefits. In most cases you can appeal a denied claim, which will take some time, but if you can prove that your claim is legitimate, you shouldn’t have a problem winning your appeal and getting your benefits within a few months.

If you become disabled due to an illness or an injury that prevents you from working, the very first step is to file a claim with your insurance provider. This is pretty straightforward and generally involves filling out a form describing your job responsibilities and the injuries that will prevent you from performing them. You’ll also need to get a statement from your doctor verifying your injury and inability to work, and outlining a treatment plan.

Long-term disability insurance pays out a percentage of your earned income. Depending on your policy, this amount typically ranges from 50% to 66% of your monthly earnings.Some policies include a cost of living adjustment, which will increase the amount 1%-6% each year to keep up with inflation

If you have a group policy, you might still consider purchasing an individual disability insurance policy for several reasons: If you terminate employment, you probably won’t be able to take the policy with you; the benefits in group disability policies are limited; most group plan benefits are taxable because the employer pays the premiums; because of benefit caps, highly-compensated individuals are often under-insured. Also, group insurance policies usually “integrate”; i.e., they are lowered by other benefits you may receive such as social security disability or state disability plans.

Individual disability insurance policies contain an elimination or “waiting period” during which no benefits are payable. Generally, you have a choice of waiting periods ranging from 30 days to one year. The longer the waiting period, the lower the cost of the plan. You should determine how long you can be without an income, based on your savings and other sources of income.

You should have enough coverage to maintain your current lifestyle until you are able to return to work, factoring in all other sources of income (group disability policy, investments, etc.).Most insurance companies will cover up to 50-60% of your income. All companies have a maximum amount they will cover.

Yes. The difference is that workers’ comp is only available if you are injured on the work site, performing duties associated with your job. Your employer pays into workers’ compensation insurance, much like how they pay sick leave or pay into unemployment insurance. However, most workers’ comp doesn’t cover the full amount of a lost paycheck.Disability insurance, on the other hand, covers injury and illness incurred in or out of the workplace, and it offers much more customization and flexibility than workers’ comp.

If you are dependent on your income and it would cease or decline if you were to become disabled, you are a good candidate for disability insurance.

As soon as you can. There are several reasons not to “put it off until later.” The most obvious reason is the cost of coverage will increase as you get older. If you are earning an income, you need to protect it now. Also, if you are currently in good health, you should have no difficulty qualifying for a policy. However, if your health declines or if you experience a disability, you may no longer be insurable (if you are still insurable, it will certainly be at a higher premium).

In many instances, the insurance carrier may pay all or part of your attorney’s fees if a denial of benefits is determined to be wrongful by a court of competent jurisdiction. Many states have statutes that require an insurance carrier to pay a claimant’s reasonable attorney’s fees if a claimant is successfully in his or her first party action for benefits. In addition, many states have statutes that provide for punitive damages for bad faith denial of claims for disability benefits.

Yes, we often engage in settlement discussions on behalf of our clients. To determine the value of an insured’s policy benefits and engage in a productive discussion with the carrier, the policy’s present value must be calculated and factors such as life expectancy, setoffs, cost of living options, automatic increases and the personal needs of the insured and his or her family must be carefully considered and factored into the negotiation.Knowledge of the factors and tactics utilized by the insurance carriers, familiarity with the company’s negotiators and their “rules” of negotiation, and a solid understanding of the legal process are paramount to a successful buyout.

If the insurance company can show that you were engaging in two or more separate and distinct occupations, then it will be necessary for the insured to show that she is totally disabled from all of her occupations to be entitled to total disability. Raising the dual occupation defense may allow the company to deny liability all together.At times, the insurer will attempt to show that secondary duties (such as a doctor taking over the administrative functions of the practice) were previously a part of the material and substantial duties of his “own occupation” and deny benefits. Thus, it is important to clearly define your pre- and postdate of disability duties.

Under most private disability insurance policies, the answer is yes. If your policy has a pure “own occupation” definition of disability, you can work in a different occupation while collecting disability income benefits. However, the duties of your new occupation must be substantially and materially different from your predisability occupation.Some policies may appear to be “own occupation” policies but have an added provision that states, “you are not working in any occupation.” If this is the case, you will typically be unable to work in an alternative occupation. You should read your contract very carefully, because you may have purchased a rider that substantially alters your definition of total disability. In particular, your rider may eliminate the requirement that you do not engage in gainful employment, allowing you to work in another occupation.

Undercover surveillance is utilized quite frequently by many insurance companies. While the investigator is not permitted to clandestinely videotape you inside your home, they can videotape you while you are out in public or even outside on your own property. Many of our clients are surprised that the investigator was able to enter their gated or protected community in order to obtain the footage

While the definition of pre-existing condition varies from policy to policy, such conditions usually come into play only if the insured claims disability within the first 12 to 24 months after becoming eligible under the policy. In that case, coverage may be denied for any condition in which the insured received medical treatment, consultation, care or services, including diagnostic tests, or took prescribed drugs or medicines within the (up to six) months just prior to the effective date of coverage and the disability began in the first 12 (up to 24) months after your effective date of coverage.oo often, however, an insurance company will mistakenly interpret a medical record, prescription or diagnostic test as a sign of a pre-existing condition, when in fact it is not. Thus, coverage may be wrongly denied under this provision.

The answer to this question depends on your definition of total and partial disability. If you have a pure “own occupation” definition of disability, you typically may collect your full total disability benefit if there is at least one material and substantial duty of your occupation that you are unable to perform due to your disability.Basically, total disability does not require complete incapacitation. In fact, in many cases you may be able to work in an alternative capacity within your profession, though you are unable to perform the duties of your actual predisability occupation, and still collect benefits.Partial disability usually means that you are performing all of the duties of your occupation, but for less time, and you suffer a loss of earned income. If this is the case, you will be eligible to collect a proportionate amount of your monthly disability benefit. If your loss of earned income is substantial enough, you will likely be eligible to collect your full benefit, even though you are still earning income in your occupation.

Policies that incorporate a residual or partial disability definition, or in which a residual disability rider was purchased, define residual/partial disability as:The inability to perform one or more of the substantial and material (major, primary) duties of your occupation.The inability to perform all of these duties for as much time as you could before the disability.You have suffered at least a 20 percent loss of monthly income.Many insurance carriers incorrectly interpret their own policy language to mean that if the insured is capable of performing at least one of the duties of her occupation, she is residually disabled and only a partial benefit is due. However, there are many instances where, despite the fact that the insured can perform one or more of her previous duties, those are not the “main” or “substantial” duties. Thus, where an insured continues to work in a limited or wholly different capacity (for example, a dentist who no longer practices dentistry but now handles all the administrative responsibilities for the practice) that insured is still totally disabled, not partially disabled, and entitled to his/her full disability benefit.

Usually, policies define total disability as the inability to perform the material duties of the claimant’s occupation. Therefore, it is the claimant’s responsibility to thoroughly explain why his/her condition prevents the claimant from engaging in those duties. Many disability applications require that the claimant clearly set forth all of his/her occupational duties, specifically breaking down each duty into categories equating to time spent performing each. If the claimant’s occupational duties are not clearly identified and specifically broken down, it can result in either a denial of the claim or a decrease in benefits. A generic occupational duties list allows the insurance carrier the ability to define the physical or mental demands of the claimant’s occupation. As such, the carrier is free to suggest that the material duties of the claimant’s job may be performed despite the claimant’s noted limitations. Moreover, the carrier may attempt to assert that certain duties are not “material” to the claimant’s occupation, rendering the claimant partially rather than totally disabled, typically lowering the claimant’s benefit.

Check with your workplace benefits specialist to find out if your company offers group disability insurance, and if you are eligible. If so, your benefits administrator can provide you with plan details.

With most group disability plans, the employer selects the maximum duration of benefits. The most frequently offered maximum benefit periods are two years, five years, and to age 65. Policies with shorter maximum benefit periods typically have lower premiums. Benefits will be paid up to the maximum duration provided you continue to the disabled during that period.

If you satisfy the definition of disability, benefit payments will begin after you have met a waiting period – a plan-defined period of time, starting with the date you are disabled from work and the number of days you must continue to be disabled until benefits begin. Most group long term disability plans have an elimination period of 90 days or 180 days. Under group plans, the employer selects the elimination period.

The definition of disability will vary depending on your employer's plan. Some policies consider you disabled if, due to sickness or accidental injury you're unable to perform the duties of your own job or occupation, while others consider you disabled if you're unable to perform the duties of any job or occupation taking into consideration your training, education and experience. Other policies require that you are unable to earn a certain percentage of your pre-disability income because of injury or sickness.Some policies may include a rehabilitation provision that gives you an incentive to take part in a vocational rehabilitation program.Keep in mind that many policies have exclusions and limitations and may not fully cover certain disabilities and pre-existing conditions. Benefits differ from company to company, so speak with your benefits administrator for your workplace’s complete plan details.

Call your disability claim manager to discuss it. The claim manager will confirm whether a formal work release is required and will support you in your return-to-work efforts.

If your disability claim has been approved, you will receive an approval letter. The letter will inform you of the amount you will be paid, the frequency of the payments, and how you will receive payments.

The claim manager will contact you and your employer to notify you both of the approval and the expected return-to-work date.

You, your supervisor, or your Human Resources representative, your family member, or your lawful representative can initiate a disability claim.

No, you cannot receive Disability Insurance benefits if you are in a rehabilitation center because of a criminal violation. These restrictions include federal, state, or other city penal institutions, jails, medical facilities, or public or private hospitals.

Vacation Pay: Yes, you can receive Disability Insurance (DI) benefits at the same time.Sick Pay: You cannot receive DI benefits for any period that you also receive sick leave wages that are equal to your full salary. If you receive only partial sick leave wages, you may be eligible for full or partial DI benefits. The first seven days of your DI claim is a non-payable waiting period. Any type of wages paid by the employer during the waiting period do not conflict with DI benefits.Other Pay: All other pay, including holiday pay, must be reported to confirm your eligibility. The first seven days of your DI claim is a non-payable waiting period. Any type of wages paid by the employer during the waiting period do not conflict with DI benefits.

School employees are not eligible for Disability Insurance benefits if: Full wages were or will be paid to the employee during the contract period when services were performed.A period of disability overlaps with a school break and the employee is not scheduled to work, does not have a history of working during the break, or does not have an additional employer.The disability period extends through the school break period.However, if the employee is not receiving wages but would have been working for extra income if not disabled (such as teaching summer school classes, tutoring, or other secondary job), then the employee may be eligible for benefits to replace the additional income.

The amount of Life Insurance cover is determined by the employer. Cover may be a fixed amount or multiples of monthly basic salary

Cancer can affect anyone — and treatment can be costly. Even quality medical plans can leave you with extra expenses to pay. Costs like plan deductibles, copays for doctor visits, and extra costs for out-of-network care can add up fast. Having the financial support you may need when the time comes means less worry for you and your family.

Yes, you can use your payment as you see fit. Use it to help cover your household bills, medical insurance deductibles, copayments, and more.

All regular, full-time and actively at work employees who are at least 18 years old and no more than 65 years old are eligible members.

Children may continue to be covered under a parent’s cancer policy until age 26.

Your benefit is paid directly to you, so you may apply the money toward your medical costs or daily living expenses as needed.

While different types of insurance allow for different age limits, most insurers will allow persons aged between 18 years to around 65 years to purchase a cancer insurance policy.

While benefits of having health insurance include a joint insurance policy for multiple members of the family, a cancer insurance policy is more dedicated. A dedicated policy will have to be purchased for each individual who wishes to be covered under a terminal illness cover.

At the time of cancer being detected at the minor stage, the insured will receive a portion of the entire Sum Assured and the insurer will waive off the successive premium payments for a certain word of time. If the cancer is again detected at a major stage, the remaining portion of the Sum Assured will be made available to the insured. Several insurers also provide an income benefit, which enables regular payments to the insured post-treatment. This amount will usually be a certain percentage of the Sum Assured and will be available monthly up to a certain period of time.

A cancer insurance policy will ideally cover expenses incurred by the insured at the time of diagnosis of the cancer, costs of hospitalisation, medication and treatment procedures opted for. Basically, you would be paid in lump sum on the diagnosis, the percentage of payment would depend on you plan and cancer stage, and this amount can then be used for all the required treatments. An ideal cancer insurance policy will cover cancer detected at the minor stage as well as the major stage.

Cancer insurance policy provides coverage in case an insured contracts cancer. It provides lump sum payments that help cover medical expenditure spanning from diagnosis to treatment. Some insurers even offer cancer insurance policies that provide a fixed income to the insured in their postoperative stage.

A vision plan will help you take care of your eyes and save you money at the same time. But vision insurance is more than that. Taking good care of your vision is important to your overall health. During your eye exam, the doctor can detect early signs of serious general health conditions so you can manage them before they become more difficult problems. This can include things like diabetes and high blood pressure.

A comprehensive eye exam includes numerous tests to evaluate your vision, eye health, and screen for health conditions such as diabetes and high cholesterol. You can also receive a prescription for corrective lenses. A vision screening will only check for potential vision problems and any concerns will usually be referred to an eye doctor.

Some vision plans may cover lens enhancements for a small co-pay. Your eye doctor can help you choose the lens enhancements that are right for you and covered by your plan.

A lens enhancement is an added feature to the lenses in your glasses that is intended to improve the quality of your experience with your prescription glasses. They include things like scratch resistance and anti-glare and you may decide on additional lens enhancements that better meets the needs of your eyes. Your eye doctor can advise if a certain lens enhancement would be good with your prescription.

A copay is the fixed amount paid by you to the doctor’s office when you visit an eye doctor. Take an eye exam for example; once you pay the exam copay, your plan will pay for the remainder of whatever your doctor charges for an exam. Copays are usually due to the doctor’s office at the time you receive services.

Your vision plan should cover an annual comprehensive eye exam, frames or contacts, and lens enhancements. Other things to consider are how often you want new glasses and your overall frame allowance. Some plans may highlight low rates, but provide an overall low frame allowance, or don’t provide a lot of savings on lens enhancements (where costs can really add up). Plus, you’ll want to make sure the doctor network includes convenient locations. Read the plan details to ensure you’re getting the right plan for your needs.

The most common life insurance offered for employees is term life insurance, meaning the term is only as long as the employee is employed. How much coverage this policy covers is up to you. Some business provide a small amount, like $10,000 to help with final expenses, where others insure the employee up to a full year of their salary.

Offering a short- or long-term disability plan is a great benefit for employees. This benefit can be employer or employee paid, but most companies opt to pay for this coverage as part of their employee benefits package.

Not every benefit has to begin on a worker’s first day at a new job. However, some benefits are required by law to begin right away. For instance, Medicare and Social Security contributions need to begin immediately. However, other benefits such as retirement options and health insurance can begin further down the line. Some employers may choose to offer health insurance once an employee has been working for the company for at least 30 days or some other length of time.Additionally, not every employee necessarily has to receive the same benefits. Health insurance may be something that business owners only offer to full-time employees, so part-time workers would be ineligible. The same perks can be applied to vacation time and pension plans.

This is no specific timetable for recovering from a traumatic event. Individuals may vary significantly in their recovery process based on a number of factors. Most people have intense but normal reactions to an abnormal event. With information, good support, coping skills and self-care, the majority of people will be able to return to a level of functioning where they can adequately and safely perform their job duties within the first two weeks. While some individuals may require longer to reach a baseline of functioning, it is important to note that some aspects of recovery for most people may take months or even years and often require ongoing attention.

Your benefits will continue as long as your appointment makes you eligible to receive them. New employees must enroll in the benefits package that matches their appointment status, and their benefits will be effective as of the date of hire.

Continue to use your medical plan as usual. If you need to pay out of pocket to receive service, please keep your receipts and contact your medical plan directly to file a claim for reimbursement.

No, if a doctor accepts Original Medicare, they must accept your Medicare Supplement plan.

No, you cannot have more than one Medicare Supplement plan. Agents & carriers are not allowed to sell more than one plan to an individual beneficiary.

Medicare Supplement plans work by covering out-of-pocket costs that the beneficiary is responsible for after Medicare has paid their portion of your medical costs. Medicare will always be billed first, then your supplement carrier will be billed the remaining balance. Depending on what letter plan you choose, you could have low to zero out-of-pocket costs.

Medicare gap insurance is a Medicare Supplement plan. It’s also known as Medicare gap insurance because it fills in the gaps in coverage that Medicare leaves to the beneficiary to pay out of pocket.

Yes. Just remember that your out-of-pocket costs will be less if you choose a physician who accepts Medicare assignment.

No, you may continue to see your own doctor. Medicare Supplement plans are convenient and flexible, giving you freedom of choice.

Check with your group plan administrator. You may be able to choose either your group plan or Medicare plus Medicare Supplement coverage. If you stay with your group health care plan, a Special Enrollment Period lets you delay purchasing Part B until you need it.

You can apply for Medicare Supplement Insurance during open enrollment. Open enrollment includes a six-month period from the date you enrolled in Medicare Part B if age 65 or older, or up to six-month after you turn 65 if you were eligible for Part B benefits before age 65. If you become eligible for Medicare Part B benefits before age 65 because of disability or ESRD (permanent kidney failure), you are guaranteed the Medicare Supplement policy of your choice during the first six months you are age 65 and enrolled in Part B.

Medicare Supplement Insurance is a private health insurance policy designed to help pay some or all of the costs that are not covered by Medicare Parts A and B.

To join a Medicare Prescription Drug Plan, you must have Medicare Part A and/or Part B. For prescription drug coverage through a Medicare Advantage plan, you must have both Medicare Part A and Part B to enroll. You must continue to pay your Medicare Part B premium.

Medicare Part D was added to help individuals pay for prescription drugs. Signing up for Medicare Part D is voluntary, although penalties may apply if you don't sign up when you're first eligible and if you don’t have other drug coverage that is equal to or better than the coverage offered by Medicare. (This is known as creditable coverage.)

If you don't join a Medicare drug plan when you are first eligible for Medicare Part A and/or B and you go without creditable prescription drug coverage for 63 continuous days or more, you may have to pay a late-enrollment penalty to join a plan later. This penalty amount changes every year, and you will have to pay it as long as you have Medicare prescription drug coverage.

You may change your Medicare Depending on your circumstances, you can switch to a new Medicare drug plan by simply joining another drug plan during one of the times listed above. You don't need to tell your old Medicare drug plan you are leaving or send them anything. You will be disenrolled automatically from your old Medicare drug plan when coverage in your new drug plan begins. You should get a letter and enrollment information from your new plan provider in the mail. Don't give personal information to plans that call you unless you're already a member of the plan.

Everyone with Medicare can get prescription drug coverage. This includes people who are 65 years or older and who are U.S. citizens or permanent residents, and people under 65 with certain disabilities, including End-Stage Renal Disease (ESRD) and amyotrophic lateral sclerosis (Lou Gehrig's Disease).

Flossing reduces the number of bacteria in your mouth. There are millions of these microscopic creatures feeding on food particles left on your teeth. These bacteria live in plaque which can be removed by flossing. Brushing your teeth gets rid of some of the bacteria in your mouth. Flossing gets rid of the bacteria the toothbrush can't get to. That's the bacteria hiding in the tiny spaces between your teeth. If you do not floss, you allow plaque to remain between your teeth. Eventually it hardens into tartar. Plaque can be removed by brushing. Only the dentist can remove tartar.

Many people do not see a dentist on a regular basis. They only go when they have a problem. This is known as "crisis treatment" versus "preventive treatment." While these patients may feel they are saving money, it often ends up costing much more in dollars and time. This is because many dental problems do not have symptoms until they reach the advanced stages of the disease process. An example is tooth decay. It is typical to hear, "Nothing hurts... I don't have any problems."Tooth decay often does not hurt until it gets close to the nerve of the tooth. It is not uncommon to see a patient with a huge cavity who has never felt a thing. The dentist can usually detect a cavity 3-4 years before it develops any symptoms. This early detection can help you prevent root canal treatment.

Dental indemnity insurance is a type of insurance that pays for your care after you’ve seen the dentist and paid upfront. In this case, you visit the dentist first, pay the cost, and then submit your claim to your provider. Your insurer will then reimburse you for part of the fee. This plan is best if you have a preferred dentist or you want a wide variety of providers. The annual coverage limit may be higher, but the monthly premiums also tend to be higher than other plans.

Dental care can be pretty expensive, especially when paid out of pocket. But dental care is absolutely essential to your health, so you can’t skip out on it.Most dental insurance plans will cover a big part of your procedures, making dental care affordable for both individuals and families. Your bi-annual visit to the dentist will be paid for in full by your provider – a benefit you can enjoy right away. Having insurance is also an excellent incentive to make more preventive-care visits even if you have healthy teeth. Less money is spent on preventive care and saves a lot of money that would be spent on costlier procedures in the future.

Like any other insurance, you have to pay monthly premiums based on the company, your area of residence and your insurance plan. Public health insurance usually doesn’t cover much (if any) dental work, so the majority is covered by private insurance.Dental insurance often depends on the dentists you want and how much you can pay. If you’ve got a dentist already and they’re part of an insurance network, then you can go for one of their plans. When your dentist is not in-network, you’ll still be covered by the insurance, although you’ll pay more out of pocket. If you don’t have a dentist, you can visit any of the dentists in the network and still be covered. Most dental insurance providers have a waiting period before any dental work can be done, typically between six months and a year. Most policies do not cover cosmetic care procedures since they aren’t a medical necessity.

When you're covered by two dental policies, the non-duplication of benefits provision describes how a secondary policy may calculate its portion of payment. The secondary policy pays as much as it would pay if it were primary, minus the primary payment amount.For example, if the primary policy paid 80 percent and the secondary policy would cover 80 percent if it was primary, the secondary policy would not make an additional payment.f the primary policy paid 50 percent and the secondary policy would cover 80 percent, the secondary policy would pay up to 30 percent.

If your former spouse’s dental coverage includes dependents, your children have coverage regardless of whether or not they reside with you or your former spouse.

Yes, children can be covered by more than two dental benefit policies. They may be covered by one or both parents and one or more stepparents. If either parent's dental policy has a "non-duplication of benefits" provision, the coverage will be subject to contract limitations.

A pretreatment estimate is also known as a confirmation of treatment & cost and/or predetermination of benefits. This is used to verify coverage of a treatment, as well as receive an estimate of your out-of-pocket cost.Estimates are recommended for more extensive procedures such as crowns, wisdom tooth extractions, bridges, periodontal surgery, dental implants and dentures.

UCR (Usual, Customary, and Reasonable) is the term used by insurance companies to describe the amount they are willing to pay for a particular procedure. There is no standard fee or accepted method for determining the UCR. The fee your endodontist charges has no relationship to the UCR. Your dental benefit plan administrator establishes the percentages that they will pay for each procedure. These decisions are often based on many factors: region of the country, number of procedures performed and cost of living.

Dental insurance is not really insurance at all. Insurance pays based on a negotiated contract to cover the cost of a loss. Dental insurance is actually a benefit provided by an employer to help their employees pay for routine dental treatment. The employer usually negotiates a plan based on the benefits provided and the cost of the premium. Most plans are designed to cover only a portion of the cost associated with dental treatment.

Sometimes referred to as fee-for-service or scheduled plans, dental fee schedule plans reimburse patients for a prearranged portion or dollar amount of their dental costs based on information in the plan carriers’ fee schedule, which lists all covered procedures and the amounts plan subscribers will be reimbursed for each. Any balance due after the scheduled fees have been reimbursed are the patient’s responsibility.

Here are 3 important reasons why anyone who doesn’t already have dental coverage should consider getting dental insurance or a discount dental plan: To maintain a healthy mouth: Preventing oral health problems before they start is one of the best ways to keep dental costs down. To cover the costs of dental care: Dental expenses can mount quickly – especially if dental work is required as a result of an emergency – so it truly pays to be covered To protect overall health: Regular checkups allow dentists to screen patients for symptoms related to more than 120 different non-dental diseases, including diabetes and heart disease.

Correct. If you stop premium payments of your policy, it amounts to discontinuation of the policy and you cannot claim any tax benefits. However, if you discontinue paying your premiums after 2 years from the commencement of your policy, the tax will not be deducted on the premium paid in the year when your policy ends. The amount of tax deducted on the premium paid in the preceding year is taxable in the year when the policy terminates.

Underwriting is the process insurance companies use to determine whether they can insure an applicant, at what amount and at what cost to the insured person.The underwriting for coverage you enroll in at work is typically faster and less rigorous than if you are buying coverage individually from another source.Since no two people are the same, underwriters analyze the risk factors unique to each applicant, which may include age, gender, current health, medical history, occupation, lifestyle habits and more.If the insurance company feels you present a greater risk — for example, if you are in poor health, have a dangerous occupation or are elderly — you may pay more for life insurance than a young, healthy individual — or be declined coverage entirely.

The primary reason to own life insurance is so that your beneficiary(ies) can receive a monetary payout — called the “death benefit” — if you pass away while you are covered under the policy.How much life insurance coverage you purchase is up to you. You can purchase an amount of coverage to correspond with what you’d like the death benefit to be used for — to pay for your final expenses, make up for the loss of your income so your family can cover their living expenses, finance care for a dependent with special needs, pay off debts or pay for your kids’ college tuition.

Consider buying now. No matter how old you are, you will never be younger than you are today. Age can be a significant factor in determining premiums. Many multi-line insurers offer discounts on either the life policy or the home or auto policy when you “bundle” all your policies with their companies, so ask if the company offers any such cost savings.

The way you structure your death benefit will depend on your family and your goals. One option is a lump-sum payout, but you also can generally have the benefit issued in monthly payments. That way your beneficiary will not receive all the benefit at once. You can even structure your life insurance to pay the death benefit into an individual retirement account (IRA), to provide savings for your spouse’s retirement.

You probably do. Most group coverages aren’t portable, which means if you lose or quit your job, you also let go of your insurance coverage. Most importantly, group coverage doesn’t offer sufficient protection and typically offers two or three times your yearly income, which by all accounts, isn’t enough. (The recommended amount is 10 times yearly income.) My advice is to get it through your job if it’s free or at a reasonable price and supplement it with life insurance outside your workplace.

Your designated beneficiary will have to file a claim with the carrier. He will also need to supply the death certificate (not a copy) along with the deceased’s policy number, social security number, and address.

Your current and past health aren’t the only parameters the carrier uses to evaluate your application for life insurance. Moreover, since life insurance is meant to protect financial devastation to your heirs, the insurance company needs to make sure you are not over-insuring yourself and that the payment is within your means.If you make 20K per year and want to purchase a 20-million-dollar insurance where the premium is so high, you can’t afford it, this will trigger a red flag, and you most likely will not be approved for coverage. Lastly, any amount you choose to buy, you must justify it through income or assets that you are trying to protect.

This question has been debated for as long as life insurance been around. For most, term life insurance will be the preferred choice because it offers the most significant benefit amount for the lowest price. Furthermore, since most expenses aren’t permanent (mortgage balance, young children), getting the most amount of coverage in the most crucial period when the family is young is a sensible option.That said, there are a few cases for a permanent policy which can be best used for estate planning or when you buy a small final expense policy.

A third-party nurse will go over the questions you answered on the application and record your pulse, blood pressure levels, height and weight, and also take a blood sample. Sometimes, depending on your age and the company, a urine sample and EKG will also be required.

This depends on who you ask and what they are attempting to sell you. A child’s policy can provide a saving vehicle, the ability to buy more coverage in the future without proving insurability and also pay the death benefit in the event of a child’s death, which can be used for burial expenses.However, most child coverages aren’t large enough to begin with (maximum benefit is typical $25,000), and they aren’t supporting a family financially, so none depends on them. Besides, cases for a child’s death are very slim, statistically, and although it may be the most tragic experience, life insurance won’t really help.

A graded benefit life insurance is method insurance carriers use to offer coverage for individuals who aren’t in the best of health and otherwise may not qualify for coverage by limiting the death amount payment should they die in the first two or three years.For instance, if you bought $10,000 in coverage, a company will pay 40% if you died in the first year, 75% in the second year, and only in year three onwards will your beneficiaries be entitled to the full amount. When buying this type of coverage, you need to proceed with caution and first try to get a level benefit plan, which has no waiting period.

Most plans do require medical testing and charge premiums based on the level of risk they assign to you based on the testing. However, even if you are not in top health or have a serious health condition, there are still some options available with guaranteed issue plans, although this comes at the cost of a higher monthly premium and a lower death benefit.

Some policies have a provision that allows you to collect a significant portion of the death benefit while you are still alive should you become terminally ill. The money can be used at your discretion to pay for medical expenses or even to do specific things with your family and friends while you still can. The amount you take out early will be subtracted from the death benefit payment along with interest.

“Fully paid up” means that you have paid enough premiums to cover the cost of the policy for the rest of your life, and the company will use the cash value to pay your premiums until you die.

Permanent policies are typically the best option if you are looking for life-long protection, or an option to accumulate a tax-deferred cash value. A portion of the premium of a permanent policy is used to build up a cash value. The cash value can be used in several different ways, including allowing you to take out a loan against the cash value, or paying your premium after your policy is fully paid up.

Premium rates are typically based on factors such as age, gender, height, weight, health status (including whether or not you use tobacco), and if you participate in high-risk activities or occupations.

If you named only one beneficiary, your life insurance benefit will go to any named contingent beneficiaries or to your estate. If you have multiple primary beneficiaries, the benefit owed to the deceased beneficiary will be evenly distributed among the remaining beneficiaries.

After you file your claim, the insurer could pay out the death benefit in as little as few as five days or as many as 45 days. If you can’t find the paperwork verifying the claim or the manner of death is suspicious, there may be delays

The death benefit is not usually taxed under normal circumstances. If you’re doing something less common like selling the policy to a third party, or distributing the death benefits in installments while the principal earns interest, there might be tax penalties for the beneficiary. There may also be estate taxes if the death benefit is included in an estate instead of paid directly to the beneficiary. Be sure to check with an accountant or financial advisor to make sure.

The insurer will disburse a life insurance policy’s entire death benefit in one payment directly to the beneficiary.In cases where there are multiple beneficiaries, the insurer will split the death benefit according to the instructions you’ve left in your contract, but otherwise still pay each recipient a lump sum.

All life insurance companies are not the same. They can differ in the level of customer service and in the variety of insurance products they sell.Even when two insurers offer what appears to be the same basic policy, each one may have different underwriting guidelines that lead to different prices. You should always comparison shop when looking for a life insurance policy.

You can’t use a credit card to pay for your recurring premiums at most life insurance companies. Most insurers will let you pay your initial premium with a credit card, and then you’ll have to use a check or electronic funds transfer for future payments.

If you pay your premiums annually instead of monthly, your life insurer may offer a small discount of 2-5%. You won't save money if you pay every six months, though some insurers will allow you to do so.

Most life insurance policies include a 30- to 31-day grace period after your payment due date (the exact period can vary by insurer or state). If you don’t pay your premium within that period, your policy will lapse and you will need to work with your insurer to reinstate your coverage.

Many employers offer life insurance as part of a benefits package. Usually, the amount is a multiple of your salary, up to a limit (usually one or two times your salary). Whether this is enough protection for your needs depends on your financial situation.Life insurance is more expensive for those who are older or in poor health, so employer-offered life insurance can be a great way to obtain coverage if you can’t otherwise afford it.

Technically a beneficiary does not have to do anything to receive your policy’s death benefit, but it’s a good idea to make sure he or she is aware that the policy exists in case there are any delays or complications on the insurer’s side.The insurer will require proof of death and a copy of the contract in order to disburse the benefit.

This depends on the plan that you chose and the hospital you go to. This care may be subject to a deductible, for example, or a hospital may have particular rules in place.

Just like different health plans cover different medications, different health plans allow you to get your medications from different pharmacies (called “in-network pharmacies”). Call your insurance company or visit their website to find out whether your regular pharmacy is in-network under your new plan and, if not, what pharmacies in your area are in-network. You can also learn if you can get your prescription delivered in the mail.

Some health insurance policies pay for specified expenses towards general health check up once in a few years. Normally this is available once in four years

Yes. When you get a new policy, generally, there will be a 30 days waiting period starting from the policy inception date, during which period any hospitalization charges will not be payable by the insurance companies. However, this is not applicable to any emergency hospitalization occurring due to an accident. This waiting period will not be applicable for subsequent policies under renewal.

Age is a major factor that determines the premium, the older you are the premium cost will be higher because you are more prone to illnesses. Previous medical history is another major factor that determines the premium. If no prior medical history exists, premium will automatically be lower. Claim free years can also be a factor in determining the cost of the premium as it might benefit you with certain percentage of discount. This will automatically help you reduce your premium.

Insurance companies have tie-up arrangements with several hospitals all over the country as part of their network. Under a health insurance policy offering cashless facility, a policyholder can take treatment in any of the network hospitals without having to pay the hospital bills as the payment is made to the hospital directly by the Third Party Administrator, on behalf of the insurance company. However, expenses beyond the limits or sub-limits allowed by the insurance policy or expenses not covered under the policy have to be settled by you directly with the hospital. Cashless facility, however, is not available if you take treatment in a hospital that is not in the network.

The term health insurance is a type of insurance that covers your medical expenses. A health insurance policy is a contract between an insurer and an individual /group in which the insurer agrees to provide specified health insurance cover at a particular “premium”

Find out how long the company has been in business. You don't want to get a really good deal with low premiums, only to find out that you can only see a doctor during very limited hours.

If you or someone in your family has a chronic condition, the policy may not cover related medical costs for a period of months -- or ever. Ask for how long pre-existing conditions are excluded.

Some plans require you to contact your doctor within 24 hours of going to a hospital emergency room, or your costs won't be covered.

Ask about any limits on choosing your doctors or hospitals. Ask for a list of the doctors and hospitals that are covered to decide if the plan is right for you.

Common exclusions under health insurance plans include cosmetic surgeries, dental treatments, treatments required due to participation in adventure sports like mountain climbing, paragliding, etc., treatments required due to self-harm like a suicide attempt, etc., therapies such as naturopathy, magnetic therapy, acupressure, and other alternative treatments.

There is no limit to the number of claims that can be made during a policy term. But the claim amount should not exceed the sum insured amount for which the insured had purchased the policy.

The pre-existing disease is an ailment, injury, or disease that the insured individual is already affected by when purchasing a health insurance policy. Conditions like depression, anxiety, sleep apnea, diabetes, etc. are considered as pre-existing diseases in health insurance.

All the hospitalization expenses incurred by the donor in organ donation except the cost of the organ during an organ transplant are included under donor expenses.

No, there is no limit to the number of claims in a year. However, it should be ensured from your end that your policy sum insured amount does not get exceeded.

Before making a health insurance policy purchase, it is advisable for you to consider your medical needs, the type of plan you want to invest in, features of the plan, sum insured options, network hospital list, exclusions, premium, and customer reviews.

Yes, buying health insurance in the early years of life comes with many benefits. Upon doing so, you may gain a lower premium amount, no waiting period, better options, accumulate bonus, lower rejection rates, and others.

If you have already been diagnosed with a medical condition, it will be considered a pre-existing disease. In this case, you may have to wait for a specific period (waiting period) until allowed coverage. Based on your insurer, you may be required to pay a higher premium or face policy denial.

If you already have an insurance policy but want to extend your cover, you can do so at the time of policy renewal.

Yes, you are free to buy another plan based on your specific medical needs

Yes! You can gain coverage for self, spouse, children, dependent parents, and multiple other relationships such as parents-in-law, siblings, and others if your plan allows.

While the eligibility age for health insurance policies differs, the general eligibility age for adults ranges between 18 years up to 65 years. The eligibility age for children lies between 90 days up to 18 years.

Your health insurance will either pay your hospital bills directly if opted for the cashless facility or it will reimburse any payment made by you towards medical expenses incurred due to an illness or injury.

You should purchase health insurance so that you don’t lose your lifelong savings while paying for medical bills in a critical situation.